Social
Associations between food instability and overall and mental well-being among US adults: Findings from the 2023 BRFSS Social Determinants and Health Equity module J’Neka Claxton* J’Neka Claxton Guixiang Zhao Machell Town
Background: Food stability is a critical public health issue that can adversely affect one’s overall well-being and mental health. Understanding the role of a social support system is crucial as it may buffer the negative effects of food instability.
Method: Using data from the 2023 Behavioral Risk Factor Surveillance System Social Determinants and Health Equity module data, we examined the associations of food instability with self-rated fair/poor health and mental health outcomes including frequent mental distress (FMD) and stress and explored the role of social and emotional support in this relationship. Food instability was defined as receiving food stamps or responding Always/Usually/Sometimes to the question of food scarcity due to insufficient funds. Cox regression with a robust variance estimator was used to estimate prevalence ratios, adjusting for sociodemographic variables.
Results: Of the 293,981 respondents eligible for the study, 20% of the population experienced food instability. Prevalence estimates for health outcomes were higher among adults experiencing food instability than those who did not. After adjustment, the prevalence of FMD, stress, and fair/poor health was 1.86, 2.29, 1.66 times higher, respectively, among those experiencing food instability than adults who did not. Prevalence for health outcomes were highest among adults experiencing food instability and low social and emotional support [defined as get support sometimes/rarely/never] (range: 41.8-43.9). Adults experiencing food instability and low social and emotional support were 3.93, 5.17, 2.39 times more likely to report FMD, stress, and fair/poor health, respectively, compared to adults experiencing food stability and high social support.
Discussion: These findings highlight the strong associations of food instability with overall well-being and mental health. Presence of strong social and emotional support may buffer some of the negative effects of food insecurity on mental health.